History Of Trauma Research Articles

Documentary cinema as social therapy: Kazakhstan’s experience in portraying collective trauma on screen

ABSTRACT This article explores the underrepresentation of collective trauma in contemporary Kazakh documentary cinema, focusing on significant historical events such as the 1931–33 famine (Asharshylyk) and the Jeltoqsan uprising in 1986. While the Kazakh film industry has embraced innovative narrative techniques and global trends, it often neglects deep-seated societal wounds. By analysing films like Chronicle of an Unannounced Demonstration (1991) and A Glimmer of the Truth (2021), this study highlights the limited cinematic engagement with unresolved historical traumas, contrasting these documentaries with narrative films that prioritise entertainment over introspection. The article argues that political influences and commercial priorities have constrained documentary cinema’s potential to serve as a medium for cultural therapy and national self-awareness. Drawing on theories of cultural trauma and collective memory, it underscores the critical need for films that confront Kazakhstan’s historical past to foster societal progress. This research situates Kazakh documentary cinema within the broader context of global trauma representation, suggesting that authentic and uncompromising approaches could catalyse a deeper understanding of national identity and historical consciousness.

Do orthodontists consider endodontic complications in their orthodontic management of teeth with a history of dental trauma? A vignette survey

BackgroundDental trauma is a frequent injury seen commonly in young children. There is a link between malocclusion and the incidence of traumatic dental injuries. Orthodontic therapy has been suggested as a preventative measure in correcting unfavourable malocclusions and potentially avoiding traumatic dental injuries. To date, it is poorly understood if the complications reported following traumatic dental injuries are amplified during and following orthodontic treatment. The aim of this study was to evaluate whether orthodontists considered the endodontic implications associated with the orthodontic treatment of teeth with a history of dental trauma.MethodA mixed methods vignette survey was designed, piloted, and distributed online to UK registered specialist orthodontists. The survey was split into three parts and consisted of three vignette clinical scenarios with open and closed questions.ResultsA total of 76 orthodontists responded from the United Kingdom. Of the participants, 46% (n = 35) of the orthodontists felt they had insufficient training in dental trauma and 42% (n = 32) lacked confidence in the treatment of traumatic injuries. The study participants reported non-standardised pre- treatment examination, limited dental trauma experience and insufficient training. In addition, 32% (n = 24) of clinicians felt that there is a lack of guidance in the orthodontic management of traumatised teeth and pulpal sequelae.ConclusionOrthodontists are not following a standardised protocol in their examination of teeth with a history of trauma prior to orthodontic treatment. There is a need within the orthodontic specialty to create a standardised protocol to assess teeth with a history of dental trauma.

Displacement Stressors, Trauma Exposure, and Mental Health: A Survey of Asylum Seekers and Refugees.

The mental health of asylum seekers and refugees (ASRs) is a pressing global concern, with complex trauma histories and environmental stressors contributing to heightened vulnerability. This study investigates the mental health and service utilization patterns of ASRs in Hong Kong, where unique policy landscapes pose additional challenges to this population. A cross-sectional survey was conducted with 100 ASRs in Hong Kong. Participants completed measures assessing displacement-related stressors, trauma exposure, mental health symptoms (depression, anxiety, stress, PTSD/CPTSD), and mental health service utilization. Participants reported high levels of displacement-related stressors and trauma exposure. The majority exhibited symptoms of depression, anxiety, and stress, with a significant proportion screening positive for PTSD/CPTSD. Despite high mental health needs, their service utilization rates were low. Trauma exposure and displacement-related stressors were significantly associated with poorer mental health outcomes, but not with service utilization. ASRs in Hong Kong face significant mental health challenges, influenced by both pre- and post-migration factors. Findings underscore higher rates of mental distress in the present sample compared to prior studies in ASRs and other local surveys. While trauma-informed care is crucial, efforts to improve mental health service access and reduce systemic barriers are needed with targeted strategies and policy changes.

Isolated architectural distortion on 3D tomosynthesis: Is ultrasound guided biopsy feasible?

Isolated architectural distortion (AD) detected on mammography is a suspicious abnormality in patients with no prior history of surgery or trauma and mandates tissue sampling. When AD is detected on routine screening and only on tomosynthesis, stereotactic/tomosynthesis guidance is needed for performing biopsy, as often there is no correlate identifiable on ultrasound. This facility is not widely available, especially in developing countries, leading to referral, delay in the diagnosis, and loss of patients to follow-up. Through this case series, we highlight the simple tips and tricks to identify the ultrasound correlate to confirm them prior to biopsy so that the correlate is accurate, thus avoiding false negative histopathology. In this series, two cases had benign results, three had a focus of ductal carcinoma in situ, and one was invasive ductal carcinoma, and the histopathological results were concordant in all these cases.

Conversion to Glaucoma After Ocular Trauma in Pediatric Patients

Background: The outcomes of pediatric glaucoma suspects with a history of ocular trauma remains unknown; we describe the rate of conversion to glaucoma of this population of patients at a research-intensive academic center. Methods: We conducted a retrospective case series of pediatric patients with a history of open- or closed-globe trauma who were being monitored as pediatric glaucoma suspects at the Wilmer Eye Institute between 2005 and 2016. Results: A total of 62 eyes from 62 patients with a history of ocular trauma were identified with a median age at presentation of 9.7 years (7.8 years) and a median follow-up of 2.7 (5.8 years). There were 29 eyes (46.8%) with open-globe injuries and 33 eyes (53.2%) with closed-globe injuries. A higher proportion of eyes that sustained closed-globe injuries were started on topical therapy for persistent ocular hypertension than eyes that sustained open-globe injuries (36.4% versus 10.3%, X2 = 5.6976, p = 0.017). Five eyes (8.1%) developed glaucoma during the follow-up period, all of which had a history of closed-globe injury (15.2%, X2 = 4.7794, p = 0.029). Four eyes of these eyes underwent glaucoma-related surgical intervention. Most eyes (3/5, 60%) that went on to develop post-traumatic glaucoma had undergone additional and/or concurrent intraocular surgical interventions to address sequelae of ocular trauma, such as traumatic cataract and retinal detachment. Conclusions: All eyes that developed glaucomatous damage or underwent glaucoma-related surgical intervention in this cohort of patients with a history of ocular trauma were those that had sustained close-globe injuries. No eyes that sustained open-globe injury progressed to glaucoma.

A Novel Tool to Communicate the Needs of Survivors of Trauma to Health Professionals: A Mixed Methods Pilot Study.

To explore the acceptability and feasibility of using a trauma-informed communication tool to convey client needs to health professionals; and to understand the barriers and enablers for clients using the tool. Mixed methods design pilot study conducted by nurses from a regional community health service in Victoria, Australia, of purposively sampled clients who have a history of sexual assault and/or family violence and clinicians from a primary care service. The investigators developed a pocket-sized communication card to convey clients' history of trauma and the clients' emotional and physical needs to health care providers. Pre-intervention and post-intervention surveys using validated scales ('Acceptability of Intervention Measure' and 'Intervention Appropriateness Measure') were administered via anonymous online or paper-based survey. Sixteen clients completed the pre-intervention survey and 12 clients completed the post-intervention client survey. Seven Nurses and three Social Workers completed the clinician survey. Both clients and clinicians reported high rates of acceptability and appropriateness of the tool on the outcome measures. The most commonly reported barriers to using the tool were clients forgetting to use the card and concern about how health professionals may respond. Content analysis of qualitative data revealed themes categorised as positive impacts (prevention of re-traumatisation), negative impacts (negative response from health professionals) and suggestions for improvement of the tool (developing a digital version, raising clinicians' awareness of the tool). This novel tool has demonstrated a high degree of acceptability and applicability in a sample of clients with a history of trauma secondary to sexual assault and/or family violence, and community health clinicians, and several positive and negative impacts have been identified. Further research should focus on larger participant numbers and include developing a digital version and a clinician education component. Use of a tool to communicate impacts of trauma may prevent re-telling of traumatic stories by clients and enhance quality of care delivery. The Good Reporting of a Mixed Methods Study (GRAMMS) has been used to report the results of this study. During development of the tool, it was reviewed by a lived experience consumer representative, the health organisations' consumer advisory panel, and a small sample of clients.

Laparoscopic peritoneal mucinous cystadenoma debulking: A case report.

Peritoneal mucinous cystadenoma is rare in the clinic, lacks specific clinical manifestations, tumor markers, and imaging features, and is easily misdiagnosed and missed. Clinical practitioners should maintain a high level of vigilance. Here, we report a case of laparoscopic peritoneal mucinous cystadenoma stripping to improve our understanding of the disease. A 34-year-old woman was admitted to our hospital with a history of epigastric pain over the past year that had worsened over the previous 4 months. The patient had no history of trauma or surgery. A computed tomography scan of the whole abdomen, as well as hepatobiliary and pancreatic scans and magnetic resonance cholangiopancreatography examinations, showed a low-density mass of approximately 5.8 × 4.8 cm between the right lobe of the liver and the right kidney. The lesion showed no significant enhancement on the enhanced scan, and analysis of tumor markers was normal. The preoperative diagnosis was cholelithiasis with cholecystitis and hepatic cysts. It was proposed to perform "laparoscopic cholecystectomy + hepatic cyst decapitation and decompression" under general anesthesia; however, intraoperative exploration revealed that the abdominal cyst had originated from the right side of the peritoneum and was located between the liver and kidney. The surgical procedure was thus changed to "laparoscopic abdominal cyst removal + cholecystectomy." The patient recovered well and was discharged on the fourth postoperative day. Postoperative pathological examination (abdominal cyst) showed mostly serous cells partially covered with high columnar mucus cells, which was consistent with mucinous cystadenoma. The postoperative diagnosis was peritoneal mucinous cystadenoma and cholecystolithiasis with cholecystitis. Clinical diagnosis of mucinous cystadenoma of the abdominal wall is difficult. The possibility of the disease should be considered when a cystic space is found in the abdominal cavity. Diagnosis depends on postoperative pathological examination, and surgery is the preferred treatment option. During the operation, attention should be paid to avoid rupture of the cyst wall and overflow of cyst fluid, and to avoid blind fenestration and drainage or puncture and aspiration sclerotherapy when the diagnosis is unclear.

My playbook: Psychotherapy role expectations, relational trauma, and trauma-spectrum mental dysfunctions in community mental health service users in Hong Kong.

Clients with relational trauma often face challenges in forming a therapeutic alliance, a primary predictor of psychotherapy outcomes. Unresolved traumatic stress can lead to a passive stance in therapy, manifested as a tendency to seek advice and approval from therapists in order to establish more predictable relational dynamics. This comes at the cost of adequately addressing their own therapeutic needs, which often leads to stagnation, treatment dropout, and frustration with the therapist. We postulated that neither relational nor nonrelational traumas could fully account for passive and maladaptive therapy role expectations, such as advice- and approval-seeking. Instead, we hypothesized that lingering effects of trauma, evident in trauma-related pathologies like dissociation, somatization, and borderline personality disorder, contribute more significantly to the tendency to adopt a passive interpersonal stance that can impede therapeutic progress. Using a sample of 259 community mental health service users, we examined the link between histories of relational trauma (both in childhood and adulthood), trauma-related pathologies, and role expectations in the psychotherapeutic interaction. Bivariate correlations revealed that history of relational trauma correlated with relationship-seeking expectation-an active way of approaching therapy. However, trauma-related pathologies were invariably related to maladaptive and passive role expectations. In subsequent hierarchical regressions, when multiple factors were entered into the model, dissociation emerged as the key factor that explains maladaptive role expectations. These findings suggest the importance of establishing clear role expectations and ensuring alignment with clients at the outset of therapy, particularly when indications of trauma-related pathologies are present. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Proinflammatory gene expression is associated with prospective risk for adolescent suicidal thoughts and behaviors over twelve months.

Recent theories have implicated inflammatory biology in the development of psychopathology and maladaptive behaviors in adolescence, including suicidal thoughts and behaviors (STB). Examining specific biological markers related to inflammation is thus warranted to better understand risk for STB in adolescents, for whom suicide is a leading cause of death. Participants were 211 adolescent females (ages 9-14 years; Mage = 11.8 years, SD = 1.8 years) at increased risk for STB. This study examined the prospective association between basal levels of inflammatory gene expression (average of 15 proinflammatory mRNA transcripts) and subsequent risk for suicidal ideation and suicidal behavior over a 12-month follow-up period. Controlling for past levels of STB, greater proinflammatory gene expression was associated with prospective risk for STB in these youth. Similar effects were observed for CD14 mRNA level, a marker of monocyte abundance within the blood sample. Sensitivity analyses controlling for other relevant covariates, including history of trauma, depressive symptoms, and STB prior to data collection, yielded similar patterns of results. Upregulated inflammatory signaling in the immune system is prospectively associated with STB among at-risk adolescent females, even after controlling for history of trauma, depressive symptoms, and STB prior to data collection. Additional research is needed to identify the sources of inflammatory up-regulation in adolescents (e.g., stress psychobiology, physiological development, microbial exposures) and strategies for mitigating such effects to reduce STB.

The prevalence of musculoskeletal pain, and the risk factor among the residents; a cross-sectional study

Background: A considerable number of resident doctors experience musculoskeletal pain during their residency years. In this study, we seek to determine the prevalence of musculoskeletal pain, as well as its associated risk factors, among a sample of resident doctors. Methods: A cross-sectional study was conducted in the Internal Medicine Department of the Faculty of Medicine, with a total of 200 residents participating in filling in the paper-based questionnaire. Standardized Nordic Questionnaire, a modified version was utilized in our study. Results: The questionnaire was completed by 200 residents. They were between the ages of 24 and 29 years old, and females were (73%). (54%) of all of them had at least one musculoskeletal pain site in the previous week, while (86%) had at least one musculoskeletal pain site in the last year. On multivariate analysis, factors associated with musculoskeletal pain in the previous week and last year were a familial history of musculoskeletal pain (p = 0.0029) (p = 0.0002), respectively, and a history of trauma (p ≤ 0.001). Conclusion: Musculoskeletal pain had a high prevalence among these residents, especially females, those with a history of trauma, and those with a family history of musculoskeletal disorders. This major health problem should be known to medical institutions, and awareness programs are required, in addition to future multicenter and larger studies.

Trauma history and persistent poor objective and subjective sleep quality among midlife women.

Whereas some work links trauma exposure to poor subjective sleep quality, studies largely rely upon limited trauma measures and self-reported sleep at one time point. It is unknown whether trauma is related to persistent poor sleep, whether associations differ based on childhood versus adulthood trauma, and whether trauma exposure is related to poorer objectively assessed sleep. We tested whether childhood or adult trauma associated with persistent poor objectively and subjectively measured sleep at two time points in midlife women. One hundred sixty-seven women aged 40-60 at baseline were assessed twice 5 years apart. At baseline, women reported childhood trauma (Child Trauma Questionnaire), adult trauma (Brief Trauma Questionnaire), demographics, depressive symptoms, apnea symptoms, and medical history, and provided physical measures. At both visits, women completed 3 days of actigraphy (total sleep time [TST], wake after sleep onset [WASO]) and reported sleep quality (Pittsburgh Sleep Quality Index). Relations of childhood and adult trauma exposure, respectively, with persistent poor sleep at both baseline and follow-up visits (TST [<6 hours], WASO [>30 minutes], Pittsburgh Sleep Quality Index [>5]) were assessed in logistic regression models, adjusted for age, race/ethnicity, education, body mass index, sleep medications, nightshift work, apnea, depressive symptoms, vasomotor symptoms, and alcohol use. Childhood trauma was related to persistent high WASO (odds ratio [95% confidence interval] = 2.16 [1.04-4.50], P = 0.039, multivariable). Adult trauma was related to persistent poor sleep quality (odds ratio [95% confidence interval] = 2.29 [1.07-4.93], P = 0.034, multivariable). Trauma was unrelated to persistent short TST. Childhood and adult trauma, respectively, were related to persistent poor objective sleep continuity and subjective sleep quality in midlife women, independent of risk factors.

South Korean videogame narratives: exploring historical trauma through interactive memory

South Korean videogame narratives: exploring historical trauma through interactive memory

Identifying and Applying a Strength-Based Research Approach in Indigenous Health

Strength-based approaches are regarded as being effective in research with communities but there are minimal examples of application as a research approach, particularly in health, with Indigenous populations, and with youth. Systemic racism manifested through colonization, including in academic institutions, has contributed to historical and ongoing traumas by supporting the overuse of deficit-based approaches with Indigenous populations in many disciplines, including health. We present our creation and application of a strength-based methodological approach to research in health alongside Dene First Nation youth. It was developed on principles consistent with the strength-based paradigms in social work, psychology, and education. We share four main components of strength-based research approach: 1) identifying strengths, 2) prioritizing and creating descriptions of strengths, 3) refining strengths by gathering contextual examples, and 4) depicting strengths to plan future research. Each component included qualitative methods (such as asset-mapping, nominal group technique, storytelling interviews, and participatory 360-degree video) that reflected aspects of strength-based approaches and emphasized active participation, multiple knowledge sources, and empowerment. Utilizing this approach promoted connectivity to the larger environment, inclusivity of multi-knowledge sources, agency and voice, increased empowerment, and practicality in action. We share challenges and lessons learned from exploring a strength-based approach in health research and provide insights for researchers interested in applying a strength-based approach to research, particularly in Indigenous health.

Long-term outcomes of scleral fixated black diaphragm intraocular lens in eyes with combined aphakia and aniridia

Purpose To evaluate long-term anatomical and functional outcomes in eyes undergoing scleral fixation of aniridic black diaphragm intraocular lens (BDIOL). Methods Total 38 eyes that underwent scleral fixation of BDIOL for secondary aniridia following ocular trauma with aphakia with absent posterior capsule or primary congenital aniridia with subluxated lens were retrospectively analyzed. Final visual acuity, early and late complications were examined. Correlation analysis was done. Results The mean follow-up was 28 months (range 6 to 66 months). The mean preoperative visual acuity of 1.82 ± 0.90 logMAR improved to 0.69 ± 0.61 ( p = 0.00). The mean spherical equivalent refractive error of 7.88 ± 4.85 diopters improved to −0.69 ± 1.52( p = 0.00). Complications were seen in 9 eyes (23.6%). Early complications were raised intraocular pressure (IOP) in 2 eyes and one eye with suture site infection which were managed conservatively. Late complications were corneal decompensation 3eyes (7.8%), retinal detachment, hypotonic maculopathy and refractive surprise in 1 eye each (2.6%). None reported IOL tilt or dislocation. The patients noticed a significant reduction in glare disability and photophobia. No significant association was found between pre-operative factors such as prior surgical procedures, history of trauma and length of follow-up with surgical outcomes. Conclusions Scleral fixation of BDIOL is an effective option in eyes with aniridia and aphakia without capsular support that have undergone multiple previous surgeries. Despite severe damage, the BDIOL helps reconstruct the anterior segment and give a good quality of vision with minimal complications rate.

COVID-19 Vaccine Hesitancy Among Black Women in the US

COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts. To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination. Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely via Zoom. Data were analyzed from June to October 2023. Identification of key themes associated with COVID-19 vaccine hesitancy, identified through thematic analysis of interview data. Fifty-four Black women aged 21 to 66 years participated in the study. Most participants (41 [75.9%]) resided in the South. The sample was predominantly well-educated, with 41 (75.9%) holding a bachelor's degree or higher. Income levels varied, with 16 (29.6%) earning between $40 000 and $59 999 annually. Regarding family structure, 32 participants (59.3%) reported having no children, while 22 (40.7%) had 1 or more children. Three primary themes emerged as being associated with vaccine hesitancy: (1) mistrust in health care and government, rooted in past medical exploitation; (2) concerns over vaccine safety and long-term effects, particularly regarding reproductive health; and (3) ineffective and coercive vaccine communication and promotion. Participants expressed deep-rooted skepticism about being treated as "expendable" in medical research, fears about the rapid vaccine development process, and frustration with coercive vaccine advertisements. Many women desired more comprehensive education about vaccine mechanisms and criticized the use of coercive financial incentives and celebrity endorsements in vaccine promotion. Addressing COVID-19 vaccine hesitancy among Black women requires a multifaceted approach that acknowledges historical traumas, provides clear and transparent safety information, and avoids coercive vaccine promotion strategies. These findings emphasize the need for health care practitioners and public health officials to prioritize trust-building, engage community leaders, and tailor interventions to address the unique concerns of Black women to improve vaccine confidence and uptake.

Clinical and radiographic evaluation of two different apexification protocols in traumatized immature permanent incisors.

Dental trauma can cause damage to the pulp tissue in immature teeth. Revascularization therapy is a possible option in the treatment of non-vital, immature permanent teeth with a history of trauma. The aim of this prospective study was to evaluate the radiographic and clinical results of immature teeth with a history of trauma treated by regenerative endodontic procedures and mineral trioxide aggregate apexification techniques. Forty-one patients aged between 7 and 12 years with traumatized immature permanent maxillary incisors were included in the study. These patients were divided into two groups: those who had previously received endodontic treatment and those who had not. Twenty-four patients who applied directly to the university clinic and had not received endodontic treatment before were included in the regenerative endodontic protocol group (Group 1). Seventeen patients who had previously undergone endodontic intervention on their relevant teeth were included in the mineral trioxide aggregate apexification group (Group 2). The patients were followed for a period of 24 months. Clinical success rates were evaluated, and pre-treatment and control radiographs were analyzed to calculate the percentage increase in root dentin width and root length. After 24 months of follow-up, positive periapical healing was detected in the radiographic findings in the majority of cases. In Group 1, a limited increase in root length and root dentin width was observed, while a narrowing in the apical opening was evident. The radiographic evaluation of two of the cases, which could be accessed 11 years later, emphasized the importance of long-term follow-up in assessing the effectiveness of the chosen methods. The revascularization method is a treatment option that has positive results in terms of root development in teeth with necrotic pulp as a result of trauma.

Elastografia Acoustic radiation force Impulse (ARFI) para auxílio no diagnóstico de dois tumores malignos da bainha dos nervos periféricos caninos

ABSTRACT: This report described the use of acoustic radiation force impulse (ARFI) elastography in the diagnosis of two cases of canine malignant peripheral nerve sheath tumors. Both patients presented with lameness in the thoracic limb and no response to previous clinical treatment or trauma history. Physical examination revealed muscular atrophy in one of the thoracic limbs, in both dogs. B-mode axillary ultrasound showed the presence of a predominantly hypoechogenic, heterogeneous, irregular, nonencapsulated nodule with adjacent reactivity, measuring approximately 20.1 mm x 15.4 mm in the first case and 18.3 mm x 10.7 mm in the second. ARFI elastography was performed, showing areas of significant stiffness, with an average shear wave velocity of 4.12 m/s (case 1) and 4.35 m/s (case 2), suggesting malignancy. In both cases, the affected limb was amputated, and the tumors sent for histopathological analysis, which were; subsequently, diagnosed as malignant tumors of the peripheral nerve sheath. The ultrasonographic methods used were essential in the diagnosis and therapeutic conduct.

Memorials and collective memory: A text analysis of online reviews.

Memorials extend beyond their physical constructs, embodying political narratives and influencing collective memory. This study examines how traditional memorials and counter-memorials shape geopolitical storytelling and public sentiment. Through text analysis of over 158,000 online reviews, we compare emotional responses elicited by these memorial types. Our findings reveal distinct differences in reactions, with traditional memorials evoking pride and heroism, while counter-memorials prompt reflection on loss and historical trauma. These results contribute to understanding how memorials influence political perceptions and collective memory, offering insights into the psychological mechanisms behind geopolitical engagement with historical events.

Cognitive factors as mediators of the relationship between childhood trauma and depression symptoms: the mediating roles of cognitive overgeneralisation, rumination, and social problem-solving

ABSTRACT Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors – cognitive overgeneralisation, rumination and social problem-solving – as mediating factors in the relationship between childhood trauma and symptoms of depression. Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling. Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies. Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problem-solving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma.

INDIGENOUS RESILIENCY AGAINST THE SOCIAL, BEHAVIORAL, AND MENTAL DETERMINANTS OF HEALTH DURING COVID-19 PANDEMIC

Abstract U.S. Indigenous people have been disproportionately impacted by the COVID-19 pandemic, experiencing higher rates of infection and hospitalization, being vulnerable to mental health symptoms, including psychological stress and emotional health, and experiencing higher rates of loss and death. Structural inequities have contributed to these negative COVID-19 health outcomes; however, consistent with the Framework of Historical Oppression, Resilience, and Transcendence (FHORT), Indigenous people offset these disparities through positive coping, adaptation, and resiliency interwoven between individual, family and community ecological levels. This research assessed interconnections of structural inequality and associated disruptions in relation to Indigenous wholistic wellness, primarily around healthcare discrimination, medical mistrust, mental health, and loss and death. Thirty-one head-of-household women participated in community-based, critical ethnographic interviews to assess disparities associated with COVID-19. All participants were in caregiving roles and ranged in age from 29-56 years old. The following themes emerged: (a) negative medical and healthcare experiences; (b) connections between physical and mental health; (c) worry and depression; (d) loss of structure and self; (e) disrupted burial rituals; (f) death, grief, and extensive losses; and (g) resiliency. Results indicate disparities associated with the pandemic emerged in large part from systemic inequity; however, Native American women demonstrated resiliency by advocating for themselves, problem solving, self-coping, and upholding Indigenous values. With lower life expectancy of Indigenous peoples, this study informs both future generations and interventions, promoting traditional and cultural protective factors to offset the impact of historical trauma and oppression, including healing across all ecological domains including physical, mental, emotional, and spiritual aspects.